Cardiogenic cerebral infarction, what disease is it

I believe everyone is familiar with cerebral infarction. Many people around you may have suffered from this disease, especially the elderly. As people's living standards improve, they are very concerned about this disease. Some people may not be very clear about what cerebral infarction is. Let's learn about it together below.

Diagnostic criteria for cardiogenic (atrial fibrillation) cerebral embolism: (1) The onset is very sudden, and the condition reaches its peak immediately; (2) The symptoms are relatively severe, because the site of cerebral embolism caused by atrial fibrillation is mainly located in the large blood vessel distribution area of ​​the brain, and Doppler examination shows no evidence of vascular stenosis; (3) There is persistent atrial fibrillation or paroxysmal atrial fibrillation before the onset of the disease, and the patient's self-palpated pulse is often irregular and of varying strengths; (4) Clinical or imaging findings of the brain indicate that the lesions are located in multiple vascular distribution areas or at the junction of gray and white matter.

When atrial fibrillation causes stroke, if intravenous thrombolysis is feasible within the 4-5 hour time window, multiple experimental results have confirmed that intravenous thrombolysis is safe and effective. Some patients do not respond well, which is considered to be related to the fact that the emboli formed by atrial fibrillation are old blood clots. Therefore, intra-arterial mechanical thrombectomy is currently a relatively effective treatment method. Mr. Zou mentioned above did not see good results after intravenous thrombolysis, but after undergoing arterial thrombectomy, the effect was very good and his symptoms completely disappeared.

However, the treatment of this type of patients should focus on treating atrial fibrillation to avoid cerebral embolism. The treatment of atrial fibrillation is divided into drug treatment and non-drug treatment. Drug therapy includes ventricular rate control, heart rhythm control and anticoagulation therapy. Non-drug treatment is intracatheter radiofrequency ablation. In terms of anticoagulant treatment, 60% to 80% of atrial fibrillation patients in Europe and the United States receive anticoagulant treatment, while domestic surveys show that only 2% of atrial fibrillation patients receive anticoagulant treatment. There are many problems with anticoagulation: whether to use anticoagulant treatment, the choice of anticoagulant drugs, the use of dosage, how to prevent bleeding, etc. Currently, the most commonly used anticoagulant therapy is warfarin, 2-3 mg/d, which can reduce the incidence of stroke, but the international normalized ratio (INR) needs to be monitored to maintain the INR at 2-3 levels. The elderly are more prone to cerebral embolism, but are also relatively prone to cerebral hemorrhage. When warfarin is used, monitoring and observation should be strengthened. Many drugs can interact with warfarin and affect its pharmacokinetics. Intracatheter radiofrequency ablation therapy Radiofrequency ablation and isolation of the pulmonary veins can terminate atrial fibrillation in about 80% of patients and maintain normal sinus rhythm, achieving the purpose of treating atrial fibrillation, thereby significantly improving the patient's event-free (stroke, etc.) survival rate.

In short, atrial fibrillation is the most common cause of cardiogenic cerebral embolism. We must pay attention to atrial fibrillation and actively treat it. If surgery or drug conversion is required, it must be performed as soon as possible. If conversion is unsuccessful, anticoagulant treatment should be performed. The effectiveness of atrial fibrillation treatment determines the incidence of cerebral embolism. If a patient with atrial fibrillation suffers a stroke, he or she should come to the hospital for treatment as soon as possible. In the early stages, intravenous thrombolysis and mechanical thrombectomy can be performed, and the effect is good.